Suicide risk assessment and safety planning in integrated primary care settings: Recommendations for behavioral health consultants

Primary care is an important setting for improving identification and treatment of people at risk for suicide. However, there are few standardized protocols for management of suicide risk in primary care. In this paper, we outline evidence-based practice considerations for behavioral health consultants (BHCs) tasked with conducting suicide risk assessments and safety planning interventions in […]

Effectiveness of suicide safety planning interventions: A systematic review informing occupational therapy

Background. Suicide safety planning (SSP) is a suicide prevention approach that involves developing a collaborative plan between a service provider such as an occupational therapist and a person who is at risk of suicide. Purpose. To synthesize effectiveness studies on SSP. Method. Using the Joanna Briggs Institute methodology, we conducted a systematic review of effectiveness studies including a: (1) title […]

LINC to Life: Evaluation of a safety planning training program with clinicians and mental health staff

Suicide rates continue to rise, and clinicians and mental health staff play a critical role in keeping suicidal clients safe. Safety planning, including means safety, may help to decrease suicide risk. Unfortunately, availability and evaluation of safety planning training for these providers are scarce. The goal of the present study was to evaluate a safety […]

The effectiveness of the safety planning intervention for adults experiencing suicide-related distress: A systematic review

The safety planning intervention (SPI) is gaining momentum in suicide prevention practice and research. This systematic review sought to determine the effectiveness of the SPI for adults experiencing suicide-related distress. Systematic searches of international, peer-reviewed literature were conducted in six databases (Cochrane Trials, Embase, Emcare, Medline, PsycINFO and Web of Science), including terms for safety […]

Staff perspectives of safety planning as a suicide prevention intervention for people of refugee and asylum-seeker background: A qualitative investigation

Background: Safety planning involves the co-development of a personalized list of coping strategies to prevent a suicide crisis. Aims: We explored the perspectives of workers regarding safety planning as a suicide prevention strategy for people of refugee background and those seeking asylum in Australia. Method: Participants attended suicide prevention training, specific to refugees and asylum seekers, at which safety planning […]

After screening: A developmentally informed approach to safety planning and stabilization (IN: Youth Suicide Prevention and Intervention, edited by J.P. Ackerman & L.M. Horowitz)

Although the last several years have been marked by significant advances in intervention efforts for youth suicide prevention, suicide remains the second leading cause of death among this age group in the United States. We discuss promising results from intervention research with the goal of informing policies for enhancing suicide prevention care for youth. Additionally, […]

Safety planning and lethal means counseling with youth (IN: Youth Suicide Prevention and Intervention, edited by J.P. Ackerman & L.M. Horowitz)

Lethal means counseling and safety planning (i.e., a written list of individualized coping strategies and sources of support) are empirically supported strategies to prevent suicidal behavior. Both approaches are often prescribed as ways to manage clients’ risk of suicide. However, there is limited guidance on how to effectively implement these strategies with youth. In this […]

Safety planning-type interventions for suicide prevention: Meta-analysis

Background: Safety planning-type interventions (SPTIs) for patients at risk of suicide are often used in clinical practice, but it is unclear whether these interventions are effective. Aims: This article reports on a meta-analysis of studies that have evaluated the effectiveness of SPTIs in reducing suicidal behaviour and ideation. Method: We searched Medline, EMBASE, PsycINFO, Web […]

Suicide safety planning: Clinician training, comfort, and safety plan utilization

Extant literature has demonstrated that suicide safety planning is an efficacious intervention for reducing patient risk for suicide-related behaviors. However, little is known about factors that may impact the effectiveness of the intervention, such as provider training and comfort, use of specific safety plan elements, circumstances under which providers choose to use safety planning, and […]

Safety planning to manage suicide risk with older adults: Case examples and recommendations

Adults age 65 and older have high rates of suicide, despite recent efforts to reduce the suicide rate in this population. One suicide prevention strategy with burgeoning empirical support is safety planning; however, there is a lack of information and resources on safety planning for older adults to support uptake of this evidence-based practice in […]

Why does safety planning prevent suicidal behavior?

Safety planning interventions have demonstrated efficacy in reducing suicidal ideation, suicide attempts, and death by suicide. Less is known, however, about potential mechanisms underlying the effectiveness of safety plans. The present manuscript provides an overview of the steps involved in safety planning, reviews literature demonstrating its efficacy, and proposes seven potential factors that may explain […]

Feasibility of peer-delivered suicide safety planning in the emergency department: Results from a pilot trial

Objective: The emergency department (ED) is an important site for suicide prevention efforts, and safety planning has been identified as a best practice for suicide prevention among ED patients at increased suicide risk. However, few ED clinicians are prepared to assess suicide risk or guide patients in the creation of safety plans. This study was […]

Safety planning: Why it is essential on the day of discharge from in-patient psychiatric hospitalization in reducing future risks of suicide

Individuals who suffer from mental illness are at an increased risk for suicide. That risk is substantially higher in the post-discharge period from psychiatric hospitalization. Safety planning intervention (SPI) is a common intervention tool that is utilized to mitigate the risk of suicide. Current research notes promising results of SPI use in the emergency department […]

Safety planning for suicidality in autism: Obstacles, potential solutions, and future directions

Suicide is the second leading cause of death among US adolescents; data from the Youth Behavior Risk Survey indicates nearly 19% of youth reported seriously considering suicide, and 9% reported a suicide attempt within the past year.  To date, suicide research in adolescents has largely been focused on neurotypical youth. Autistic youth experience elevated risk […]

Alliance-focused safety planning and suicide risk management

Patients’ interpersonal vulnerabilities and problems represent major distal and proximal risk factors in the etiology of suicide. These can be triggered by the interpersonal demands of therapy and safety planning and impede the development of a strong therapeutic alliance, and thus, the effectiveness of safety planning. This article proposes that the principles put forth by […]

An open trial of a suicide safety planning group treatment: “Project Life Force”

In 2008, the Department of Veterans Affairs mandated that clinicians oversee the construction of a Suicide Safety Plan for every patient who is identified as “high risk” for suicide. While the Suicide Safety Plan is a mandated “best practice,” there are currently no recommended guidelines for its augmentation in a group setting. To address this […]

Safety planning for youth with suicide risk: A clinical audit

This quality improvement activity examined Safety Planning Intervention (SPI) over two 3-monthly periods for presentations from 13–17-year-olds with suicidal risk to a regional hospital Emergency Department (ED). We collected patient demography, presentation characteristics, presentation rate, and clinician use of SPI, including those under Emergency Examination Authorities (EEAs). An education workshop was offered between the audits, […]

Safety planning-type interventions for suicide prevention: Meta-analysis

Background: Safety planning-type interventions (SPTIs) for patients at risk of suicide are often used in clinical practice, but it is unclear whether these interventions are effective. Aims: This article reports on a meta-analysis of studies that have evaluated the effectiveness of SPTIs in reducing suicidal behaviour and ideation. Method: We searched Medline, EMBASE, PsycINFO, Web […]

Coping with suicidal urges: An important factor for suicide risk assessment and intervention

Suicide-related coping refers to strategies for adaptively managing suicidal urges and can be important an important factor for assessing risk and targeting intervention. The current study evaluated whether suicide-related coping predicted a suicidal event within 90-days, independently of other known risk factors. Veterans (N = 64) were evaluated shortly after a suicidal crisis and completed several assessments, […]

The safety planning assistant: Feasibility and acceptability of a web-based suicide safety planning tool for at-risk adolescents and their parents

Suicide safety planning is an intervention to assist individuals with suicide ideation in maintaining safety during a suicidal crisis. However, safety planning with adolescents is complicated by adolescents’ limited access to coping strategies at school and lack of financial means and transportation for social activities. Adolescents also rely on parents for means safety and seeking […]

Dissemination of the Safety Planning Intervention (SPI) to university counseling center clinicians to reduce suicide risk among college students

Suicide risk on college campuses remains a pervasive problem. Structural deficits in current clinical care models often result in sub-optimal treatment for suicidal students. This study reports on the feasibility, acceptability, and utility of the Safety Planning Intervention (SPI), a brief, empirically validated, clinician-administered suicide prevention intervention, in a university counseling center (UCC) setting. A […]

Augmenting safety planning with text messaging support for adolescents at elevated suicide risk: Development and acceptability study

Background: Suicide is the second leading cause of death among adolescents. A critical need exists for developing promising interventions for adolescents after psychiatric hospitalization who are at a high risk of experiencing repeated suicidal behaviors and related crises. The high-risk period following psychiatric hospitalization calls for cost-effective and scalable continuity of care approaches to support […]

Perceived utility of the internet-based safety plan in a sample of internet users screening positive for suicidality

Abstract. Background: The Internet may offer resources for individuals who struggle with suicidality but have no access to other resources or fail to use them. Aims: To develop an automated, self-guided Internet-based safety plan (IBSP), and to evaluate its use and perceived utility among individuals who report suicidality online. Method: Participants (N = 150) were recruited from a depression/suicide screening website. Participants […]